Prevalence of Goiter and Urinary Iodine in 6-11 Years Old
Students of Yazd in the Year 2002.
H. Mozaffari Khosravi PhD1*, A Dehghani MSc2, M. Afkhami MD3
1- Assistant Professor, Dept. of Nutrition, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2- Academic Member, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3- Assistant Professor, Dept. of Endocrinology Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Background: Iodine deficiency disorders (IDD) are among the most important epidemic disorders in the world and also in our country. The surveillance of IDD may be implemented to: assessing the prevalence of IDD, identifying the high risk areas for intervention and monitoring and evaluateing IDD control programmes, as salt iodized programme. The aim of this study was to determine the total goiter rate (TGR), urinary iodine in 6-11 years old students in Yazd city 10 years after iodized salt program.
Materials and Methods: In this study, 1989 primary school students (1367 boys and 622 girls) aged 6-11 were selected by multistage “probability proportionate to size” cluster(PPS) sampling method in Yazd city. Thyroid examination and goiter classification were made according to WHO standard protocol by two trained physicians. Urine and household salt samples were collected from one-thirteenth of the total population (140 individuals). Urinary iodine was determined by digestion method. Salt iodine was determined by rapid test kit.
Results: TGR of Yazd city was 40.2% (Girls 41% and boys 39.9%). Prevalence of goiter grade 1 and grade 2 were 38.7% (39.2% for girls and 38.5% for boys), and 1.5% (1.8% for girls and 1.4% for boys), respectively. The rate of goiter was not significant between the two sexes). Age specific TGR at 6-6.9,7-7.9, 8-8.9, 9-9.9 and 10-11 age groups were 39%, 37.7%, 42%, 40% and 42.1%, respectively. Age spesific goiter grade 1 in this age groups were 38.7%, 35.2%, 40.5%, 38.8% and 39.9%, respectively. Age spesific goiter grade 2 in this age groups were 0.3%, 2.3%, 1.5%, 1.3% and 2.2% , respectively. TGR in this age groups were not significant(p=0.3).
The mean of the urinary iodine was 258±122 μ g/l (244 ± 115 and 265 ± 125 μ g/l) in girls and boys respectivly, which were not significantly different.
In general, 10% of Yazd study population had urinary iodine concentrations less than 100 μ g/l, 26.4% were in adequate range (100-200 μ g/l), 63.6% were higher than 200 μ g/l the urine iodine 40.7% of the 3rd group were higher than 300 μ g/l.
In general, 3.2% of household salt samples did not contain iodine, 5.6% had 15ppm level, and 91.2% had above 30ppm level. Thus, approximately 96.8% of salts had iodine.
Conclusion: The results of this study indicated that TGR, specially goiter grade 2, had significantly decreased in Yazd, and according to urinary iodine status, not only the mean of urinary iodine was elevated, but also was higher than ideal range of WHO. Thus, according to this index, it can be concluded that since the year 2002, Yazd city is IDD free.
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Key words: Yazd city, Iodine Deficiency, Endemic goiter, Urinary iodine, Iodized salt, primary Students
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* corresponding author, Tel: (0351) 7249333
Journal of Rafsanjan University of Medical Sciences and Health Services, 2004, 3(2):96-10 3
The Effect of Zinc Supplementation on Treatment of Acute Watery Diarrhea in 1-4 Year Old Children
M. Noori Shadkam MD-MPH , H. Mozaffari Khosravi PhD
Received: 04/03/06 Sent for Revision: 26/07/06 Received Revised Manuscript: 12/02/07 Accepted: 01/03/07
Background and Objective: Patients with diarrhea are susceptible to zinc deficiency. Zinc deficiency can cause growth retardation, delay in sexual maturity, behavior disorders, persistent diarrhea and abnormalities of immune system, susceptibility to respiratory and gastrointestinal infections and impairment of taste and smell perception. The aim of this study was to evaluate of the effect of oral zinc supplementation on the treatment of acute watery diarrhea.
Materials and Methods: This study was a randomized double-blind placebo controlled clinical trial that was carried out in 139 children, aged 1 to 4 years, with acute watery diarrhea referred to two out-patient pediatric clinics in Yazd. Participants were randomly divided into two groups, zinc group (ZG) and placebo group (PG). The former group received zinc sulphate 2 mg/kg qd orally for 10 days and the latter group were treated with saline-dextrose solution (1/3:2/3). Duration and frequency of the diarrhea episodes were recorded in each group. Data were analyzed using Chi-square and Student t-test.
Results: The mean frequency of diarrhea at the first visit in ZG and PG groups were 4.6±1.7 and 4.2±1.5, respectively (p=0.1). At forty-eight to 72 h post-intervention, these values were 2.32±1.43 and 3.84±1.34 for girls (p=0.001), and 2.21±1.49 and 3.9±1.8 (p=0.001), for boys respectively. In general, after five days intervention, 45 patients (43%) were recovered, that 24 (53%) of them were from ZG. However, 10 days after the intervention the recovery rate in the ZG was markedly higher than the control group. At the end of the intervention, 80 (77%) patients, with 50 cases (66%) belonging to the ZG completely recovered.
Conclusion: This study showed that oral zinc supplementation (2mg/kg qd) in children with acute watery diarrhea reduces the duration and severity of diarrhea.
Key words: Acute Watery Diarrhea, Zinc Supplementation, Treatment of Diarrhea
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